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Four key approaches to change SeCtion one
Case Study B:
Lean in a care management team
Background
The local authority brought together social workers and care managers from the older people, physical disability and learning disability teams into generic adult teams. Management posts were reduced, with team managers required to manage bigger teams and work outside their previous user group specialism. Alongside saving money by reduced management costs, the change aimed to deliver a more holistic service by removing the barriers that existed between the specialisms. It also hoped to improve assessment and care planning practice so that more people took up direct payments and were encouraged to rely on their own networks and resources rather than funding from the local authority. In general staff supported the principles of greater self-direction and use of community resources, but were cynical that the main interest of the local authority was to save money not improving quality of life of service users. The social workers often had a strong allegiance to their previous specialism and their ways of working– this was accompanied by a lack of interest or confidence in working with other user groups.
Case Study Manager B
Manager B was the new Team Manager. He previously managed an older people’s care management team.
The Organisational Brief to Manager B
To ensure that the team works together to ensure that all of the service users and their families are supported.
To oversee a change in practice which leads to service users and families relying more on their own resources and use direct payments to supplement these.
The overall approach to change
The previous specialist teams had different strengths but also weaknesses in relation to their care management processes. For example, the older people’s team performed strongest in relation to meeting assessment timescales, the physical disability team had the highest proportion of people receiving direct payments, and the learning disability team were seen as being highly competent in relation to safeguarding. Manager B reflected therefore that he needed to ensure that the new team developed processes that combined the best of previous practice whilst phasing out of what had not worked well. The local authority had created a central team with expertise in improvement methodologies, and from discussions with them it was suggested that Lean could be a useful approach. The improvement team agreed to work with Manager B on implementing the approach.
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